DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20194720

Comparison of hematological parameters among newborns with meconium stained amniotic fluid and clear amniotic fluid

Preeti Garg, Shruti Saxena

Abstract


Background: Meconium stained amniotic fluid is an indirect marker of fetal hypoxia. Fetal hypoxia affects bone marrow and affects production of cell lines. Indirect marker of erythropoietin activity is nucleated red blood cells count. Aim of the study is to compare hematological parameter in newborn born with meconium stained liquor and clear amniotic fluid. Also, to determine cut off levels of nucleated RBC as marker of fetal hypoxia in meconium stained amniotic fluid(MSAF).

Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo medical college and hospital, Indore. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Cord blood samples were collected and hematological parameters were compared.

Results: Hemoglobin % and WBC counts were seen in study group in comparison to control group, which is statistically significant (P<0.05). The reported NRBC/100 WBC between the two groups was statistically analyzed. The mean NRBC count in study group were 8.09±6.09 which was statistically higher than the corresponding values in control group 2.07±2.25 (P<0.05).

Conclusions: Study concluded that the hemoglobin levels , WBC and NRBC counts in babies with meconium stained amniotic fluid is higher than those babies delivered with clear amniotic fluid and NRBC can be taken as a surrogate marker of hypoxia in a resource limited setting.


Keywords


Gestational age, Hypoxia, Hemoglobin, Meconium stained amniotic fluid, Nucleated red blood cells, White blood cells

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References


Soukka HR, Kero PO, Kääpä PO. Biphasic increase in plasma endothelin concentration and pulmonary vascular resistance after meconium aspiration in pigs. 2087. Pediatr Res. 1996;39(S4):350.

Teramo KA, Widness JA. Increased fetal plasma and amniotic fluid erythropoietin concentrations: markers of intrauterine hypoxia. Neonatol. 2009;95(2):105-16.

Widness JA, Teramo KA, Clemons GK, Garcia JF, Cavalieri RL, Piasecki GJ et al. Temporal response of immunoreactive erythropoietin to acute hypoxemia in fetal sheep. Pediatr Res. 1986;20(1):15.

Jazayeri A, Politz L, Tsibris JC, Queen T, Spellacy WN. Fetal erythropoietin levels in pregnancies complicated by meconium passage: Does meconium suggest fetal hypoxia?. Am J Obstet Gynecol. 2000;183(1):188-90.

Mandel D, Littner Y, Mimouni FB. Nucleated red blood cells in polycythemic infants. Am J Obstet Gynecol. 2003;188(1):193-5.

Shurin SB. Hematologic problems in the fetus and neonate. Chicago; Mosby-Year Book;1992:941-6.

Caruncho MMP, Espiritu-Dolendo R. Nucleated erythrocytes in meconium-stained infants. Available at: http://www.herdin.ph/ index.php/ component /herdin/?view=research&cid=30939. Accessed 15 Dec 2015.

Dollberg S, Livny S, Mordecheyev N, Mimouni FB. Nucleated Red Blood Cells in Meconium Aspiration Syndrome. Obstet Gynecol. 2001;97:593-6.

Tungalag. L, Gerelmaa. Z. Nucleated Red Blood Cell Counts in Asphyxiated Newborns. Open Sci J Clini Med. 2014;2(1):33-8.

Darkhaneh RF, Asgharnia M, Yousefi TZ. Comparison of NRBC in term neonatal umbilical cord blood between neonate with meconium-stained amniotic fluid (MSAF) and clear amniotic fluid. J Turkish-German Gynecol Assoc. 2008;9(2):29-31.

Hanlon-Lundberg KM, Kirby RS, Gandhi S, Broekhuizen FF. Nucleated red blood cells in cord blood of singleton term neonates. Am J Obstet Gynecol. 1997;176(6):1149-56.

McCarthy JM, Capullari T, Thompson Z, Zhu Y, Spellacy WN. Umbilical cord nucleated red blood cell counts: normal values and the effect of labor. J Perinatol. 2006;26(2):89.